The team at 4Directions Counseling offers an integrative practice model with a holistic approach to addressing your current goals. As a collective, we treat the whole person and family.

The 4Directions team uses a strengths-based approach, meeting each patient where they are in their current circumstances, together with each client, we build a plan to move forward based on their individual goals.
Our experienced counselors provide an extensive list of Specialties and Services, including:

Individual Therapy

At 4Directions Counseling, we understand the importance of effectively helping individuals overcome personal challenges and lead full and healthy lives. While providing an environment of empathy and acceptance, we facilitate client’s efforts to look inward and develop insight into whatever obstacles they may be facing. With our guidance and support, clients identify patterns of behavior or thoughts that may interfere with their health, their relationships and their experience of daily life. We help alter these patterns so our clients may find more satisfaction and joy in their lives.

Couples and Relationship Counseling

Couples counseling is structured specifically to help clients deal with the challenges in their relationships. We are trained in several styles of therapy that help people better understand their relationship dynamics and the obstacles and struggles they face together. While guiding the process of learning, healing, and reconnection, we provide clients with greater understanding and empathy that provides the means to sustain healthy patterns in their relationships. We provide a supportive space for all relationships.

Sex Therapy

Sex therapy is a unique and specialized form of professional counseling designed to help women and men address their concerns and issues about their sexuality, sexual function, and/or sexual expression. While other issues may arise during therapy, these may include the following problems:

  • Desire or frequency discrepancies
  • Arousal or inability to reach orgasm
  • Sexual anxieties and inhibitions
  • Painful intercourse
  • Sexual identity or orientation issues
  • Premature ejaculations (rapid ejaculation)
  • Erection problems
  • Medical problems affecting sex,(i.e. ostomy bag, incontinence, pain)
  • Unusual sexual desires or behaviors
  • Issues related to sexual expression or function

Like any therapeutic experience, sex therapy involves talking, listening and education. A trained counselor works with each client in a private and confidential setting to clarify their particular issues. During therapy, the therapist provides education about pertinent sexual issues, including anatomy, physical response, and healthy sexual behavior. Therapy will never involve any form of sexual or inappropriate physical contact between therapist and client, nor will the performance of any sexual activity be part of any therapy session.

Pelvic, Genital, and Sexual Pain and Dysfunction

Chronic pelvic pain and associated genital and sexual dysfunctions can affect someone’s life in a myriad of ways, including their most intimate relationships. It often takes multiple visits to a variety of physicians and specialists to find accurate diagnoses and appropriate care. It is our mission to offer a team approach as we collaborate with and help you identify the best providers for your specific situation. Our clinicians are trained by some of the best pelvic and sexual pain specialists in the country and provide direct referrals to the resources you need.


We offer short- and long-term counseling for those seeking letters to physicians for their Hormone Replacement Therapy (HRT) and top- or bottom-surgery.

Sexual identity unfolds over time and experience.  Whether you are straight, gay, bisexual or any other sexual identity, understanding your sexual identity and incorporating it into your life and relationships in a meaningful way is paramount to healthy living.  The team at 4Directions offers a nonjudgmental environment to understand and grow healthy selves that incorporate all aspects of life and relationships.

Hypnosis & Neuro-Linguistic Programming

Dr. Milspaw and Charlie Curtis provide specialized sessions utilizing hypnosis and Neuro-Linguistic Programming (NLP) interventions to achieve optimal results for all goals relating to mental, emotional, physical, and spiritual health and wellness. Click here for more information about these providers.

Listen to Dr. Milspaw’s interview with Dr. Charlie Curtis on utilizing hypnosis and Neuro-Lingusitic Programming here

Group Therapy

Often a great path forward is to meet with others who share a similar experience for a facilitated discussion with a counselor who can assist in bringing new skills and meaning to their life.  At any age, individuals can obtain new insight into their particular issue by sharing and talking with peers. Groups last between 6 – 15 weeks based on the subject matter.

For a list of current and upcoming groups, please click here.

Mindfulness-Based Stress Reduction for Pain, Stress Management, and Trauma

Research on the physiological process of pain, stress, and trauma has exploded in the past 10 years. The conclusion is clear: Mindfulness-Based Stress Reduction (MBSR) is a proven method to heal the damage caused by chronic stress, pain and trauma. The brain exercises involved in MBSR help heal the physiological components of the brain involved with the nervous system’s response to incoming stimuli.